[Prognostic factors in idiopathic myeloid splenomegaly]

The study of the evolution of 168 cases of idiopathic myeloid splenomegaly allowed to point out the prognostic value of the clinical, hematologic, isotopic and radiological parameters. The correlation of these data with the histological type of the osteomedullary lesions at the time of the diagnosis, allows to confirm the long survival of the hyperplastic formes (type I), and the more reserved prognosis in advanced myelofibroses (type II and type III together) without it being possible to bring out a significant difference between the average presumption of survival of type II and type III considered each separately. Indeed, average survival is of 82 months for type I, and 60 months for type II and type III together. The regrouping of these two types seems to be justified and allows to individualize two anatomoclinical forms. One is characterized by hyperplastic marrow with reticulinic fibrosis, usually associated with enlarged spleen and sometimes even with polyglobulia but without radiological bone lesions. The other form is characterized by a marrow of middle importance or frankly hypoplastic, fibrous, with or without osteosclerosis, and shows moderate or marked radiological changes (respectively 16,9 p. 100 of the cases, and, as a rule, pancytopenia.